2019 Henry and Angeline Van Poppel Scholarship App

TOLEDO COMMUNITY FOUNDATION, INC.
HENRY COUNTY COMMUNITY FOUNDATION
Henry and Angeline Van Poppel Scholarship
2019 Information Sheet
PURPOSE
The purpose of the Henry and Angeline Van Poppel Scholarship is to provide post-secondary education
scholarships for graduating high school seniors who are residents of Henry County, OH planning to
pursue studies in the field of general agriculture or a related/closely related field – such as agribusiness,
agricultural economics, agronomy, animal science, veterinary medicine, biotechnology, crop and weed
sciences, etc.
2018 QUALIFICATIONS FOR ELIGIBILITY
1. Applicant must be U.S. citizen;
2. Average to above academic achievement, as demonstrated by an applicant’s GPA and college
entrance test scores; and
3. Family and/or individual income level which may preclude an applicant from receiving
some financial need based grants and/or scholarship awards.
Recipients awarded a scholarship for their initial year of post-secondary education may apply in
subsequent years for a scholarship award, provided they have maintained at least a 3.0 GPA and continue
to pursue studies in the agricultural field.
BASIS FOR SELECTION
Scholarship recipient(s) will be chosen by a special committee of the Henry County Community
Foundation based on information submitted on the scholarship application form and all attachments (as
noted below).
HOW TO APPLY
1. Complete scholarship application form.
2. Obtain and attach:
a. An official copy of your most recent transcript;
b. Two letters of recommendation (teachers, school administrators, employer, etc.);
c. A sheet listing extracurricular activities which should include school and community activities.
Please note offices held and any honors received.
d. Document demonstrating your acceptance to the college or university.

e. Essay (500 word maximum) stating how you decided upon your major and career goals after you
have completed your education.
3. Submit all application materials to: Henry County Community Foundation, Inc.; ATTN: Mr. Dusty
Sonnenberg; 611 North Perry Street, Napoleon, OH 43545 April 1st, 2019.
The above-stated criteria may be revised from time to time as deemed appropriate by the Board of
Trustees of the Toledo Community Foundation, Inc., advised by the special committee of the Henry
County Community Foundation.


TOLEDO COMMUNITY FOUNDATION, INC.
HENRY COUNTY COMMUNITY FOUNDATION
Henry and Angeline Van Poppel Scholarship
2019 Application
INSTRUCTIONS
Before completing this application please review the accompanying Scholarship Information Sheet, noting
the qualifications for eligibility.
1.

Please print (in ink) or type all information; if an item does not apply to you, indicate N/A.

2.

Mail completed application and support materials (as noted on the Scholarship Information Sheet ) to: Henry
County Community Foundation; Attn: Mr. Dusty Sonnenberg; 611 North Perry Street, Napoleon, OH
43545 by April 1st, 2019. Questions can be directed to Dusty Sonnenberg at (419) 966-7181.

PERSONAL INFORMATION
Last Name__________________________________________First
Name_______________________________MI_________
Last 4 digits of Social Security Number XXX-XX-____________ Gender:___ M ___ F Date of Birth__________________

Permanent Address: Street___________________________________________________________County________________
City___________________State ______________________Zip____________ Phone (

)_________________________

E-mail address_______________________________________________________
Father’s Name/Guardian’s Name ___________________________________________________________________________
Occupation ____________________________________________________________________________________________
(Position)

(Company)

Mother’s Name/Guardian’s Name __________________________________________________________________________
Occupation ____________________________________________________________________________________________
(Position)

(Company)

List the names and ages of all persons (excluding those above) residing at your permanent address:
Name_________________________________Age________
Name___________________________________Age________
Name_________________________________Age________
Name___________________________________Age________

EDUCATION
High School Graduation Date____________________

Cumulative GPA____________

Composite Scores:

ACT _____
or SAT (excluding writing section) _____________
College, university or other school you will attend for the 2019-2020 academic year________________________________
Degree you are pursuing ______________________________________________
How many years will your academic program take to complete? _________________________________________________


EDUCATIONAL FUNDING
List any scholarships, grants, and/or other awards (for the 2019-2020 academic year) you have received as of this time. Indicate
if they are renewable or one-time awards:
Source___________________________________________Amount__________________Renewable? __________________
Source___________________________________________Amount__________________Renewable? __________________
Source___________________________________________Amount__________________Renewable? __________________
List any scholarships, grants, and/or other awards for which you have applied (for the 2019-2020 academic year) and are
awaiting a decision. Please include an approximate date as to when you will be advised of a decision:
Source_____________________________________________Amount__________________Decision___________________
_
Source_____________________________________________Amount__________________Decision___________________
_
Source_____________________________________________Amount__________________Decision___________________
_
Do you currently have a job? _______________ If so where? ____________________________________________________
How do you plan to spend your summer break? _______________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
List your anticipated costs for the 2019-2020 academic year:
Tuition & related fees____________________________Books___________________Room & Board___________________
Do you plan to reside on campus? __________
I hereby certify that the information provided on this application is, to the best of my knowledge, true and correct. I agree, if
requested, to provide the Foundation with additional information needed to determine my qualification for this scholarship. If I

become a scholarship recipient, and if requested by the Foundation, I agree to furnish reports that can be used to determine my
academic progress and use of scholarship funds. Further, I give my permission to the Henry County Community Foundation to
release any pertinent information for publicity purposes.
Applicant’s Signature___________________________________________________________Date_____________________
If Applicant is Under Age 18
Parent/Guardian Signature _______________________________________________________Date ____________________